Home Care Sees Payment, Tech Opportunities On Horizon

By Emily Study | June 4, 2014

The number of people who are more likely to receive home care is increasing as the proportion of people age 65 and older grows — forcing health care organizations to map out strategies to meet their customers’ demands.

In a recently released study, Deloitte details the opportunities and challenges of care provided inside the home, and concludes that consumers’ demands will be met with new and expanded payment delivery models through state Medicaid programs.

“In the health care industry’s quest for lower costs and higher quality, regulators, providers and payers are piloting new value- and outcomes-based payment and care delivery models,” the study reports.

Among these models are: Accountable Care Organizations and shared savings programs; payment bundling; and patient-centered medical homes and health homes. Public (Medicare) and private ACOs are estimated to cover more than 18 million insured individuals.

Under payment bundling arrangements, providers “receive a single payment for an episode of care and will share savings from more efficient ways of delivering services,” the study reports.

The success of these models, according to the study, is measured by “fewer hospital admissions and readmissions, less emergency room care, better chronic care management and lower total cost of care.”

Being able to deliver better outcomes, though, will require home health providers to invest in new staff and ways to deliver more skilled care.

In addition, the study also outlines evolving technology that is “expanding traditional home health services into the practice of in-home, technology-enabled primary care.”

Increasing a virtual connection between consumer and provider — through the use of home health care-related mobile applications — is a growing trend that has helped cut medical supply costs by 20 percent per home health visit, the study shows.

Other examples of primary care delivered in non-traditional settings include monitoring devices, telemedicine, email by physicians and e-visits by physicians.

Finally, the study explains Medicaid’s emphasis on quality and personal choice, and says Medicaid offers opportunities for states to cover home- and community-based services.

“States can offer HCBS through two traditional channels: home health services benefits (both mandatory and optional) via the state plan and 1915(c) HCBS waivers,” it says.

However, health care organizations face steep Medicare-related challenges, such as payment cuts; penalties for readmissions; single payment assessment across post-acute care; fraud and abuse focus; and pay for performance in home health.

Ultimately, the demand for efficient home health care is expected to grow, and the most successful providers and partnerships will need to demonstrate the ability to cut costs and improve patient outcomes.